Take a deep breath … but not too deep
The room fell silent. We each slowly breathed in and out,
being very curious about the sensations of a simple breath. I could feel my
body relaxing more and more with each breath.
I looked up at the middle-aged woman and her daughter. Their eyes were
closed, their faces softened and content. Even Ben, the medical student, seems
to have found a moment of deep peace after a hectic clinic day.
Fifteen minutes earlier, the consultation had started out in
a routine fashion. Margaret had been through an uncomplicated breast cancer
surgery, and was to see me for radiotherapy.
Dressed immaculately in a soft cream-coloured suit, she stood to greet
me, beaming and holding my hand in hers.
“It’s such a pleasure to meet you. I feel so grateful. I’ve read about
you online and really like your holistic approach….” She is gushing with
enthusiasm, speaks of nursing her mother through a recent diagnosis, and the
wonderful care she received at the cancer centre. The lines come one after another. She also
admits she’s anxious, takes the occasional nerve pill, has always been scared
of hospitals. I listen and we joke,
enjoying each other’s company.
Her daughter, a lovely woman in her late thirties, sits
beside her Mom smiling. She’s travelled from afar to be there around the time
of the surgery and radiation. The young
woman winks at me, as if to say ‘I know my Mom is anxious’ and when I begin my
physical exam by feeling her Mother’s neck from behind she chirps in “Look Mom,
you’re getting a free massage too.”
Her mother in the meantime is trying to settle herself down
by doing a deep breathing exercise. Her shoulders heave under my hands, and I
notice that she continues to hyperventilate with her eyes closed when I ask her
to lie down. My inclination is to let
her know ‘you’re breathing is making you feel worse’ but I wait till we are
sitting down again.
Margaret tells me she’s claustrophobic and wants to take a
valium prior to each treatment. I describe that people lying on the radiation
machine have lots of space around their faces (not like an MRI scan). I suggest
she can learn a relaxation and visualization technique from a psychosocial
specialist that she could practice to reduce any anxiety she might have prior
to or during her treatment. Ben agrees
to take Margaret on a tour of the radiation treatment machines so that she
might feel less anxious about the unknown.
Margaret’s daughter pulls out her cell phone to show her
mother a simple animation to teach the relaxation breath. A ball rises up for
five seconds in a tube of slowly bubbling water, then drops slowly down to the
bottom of the column over the next five seconds. The pattern continues. This
app can be adjusted for varying times of up-phase and down-phase. Margaret peers
into the phone and tries to time her breathing to correspond with the ball
movement. Again her chest is heaving with each in-breath.
I have to stop the exercise. I’m delighted that they are so
pro-active in empowering themselves to learn this essential healing skill – but
Margaret’s technique is not helping her.
I offer a short explanation before we practice the breathing technique
again.
Learning to tap into the relaxation response when we feel
stressed is an essential healing skill. The concept is to activate the
parasympathetic nervous system, invoking relaxation, by tricking our mind into
believing everything is completely fine using the body’s ability to engage a
specific breathing technique. This is what I call the body-mind connection (the
signals go from the body to settle the mind).
When we breathe slowly and deeply into the abdomen (instead of breathing
into our chests), we engage the diaphragm (the muscle that separates our lungs
from our abdominal organs) and the vagus nerve that stimulates the relaxation
centre in our brain. If the out-breath
is longer than the in-breath, then the relaxation effect is further enhanced. The point here is that using the upper chest
and ribs and lifting the shoulders to breathe causes more of the stress reaction. Meanwhile, breathing into one’s belly instead
of one’s chest promotes relaxation.
I take Margaret, her daughter, and the medical student
through the following technique:
1.
When
you recognize you’re stressed, press the ‘pause’ button
2.
Become
very curious about the sensations in your body (stay curious). Let go of the thoughts about the situation.
3.
Take
four slow breaths deep into the abdomen (or belly). Allow the shoulders and
upper chest to be still or quiet. Try
lengthening the out-breath compared with the in-breath.
4.
Use
the kind and wise part of your brain to direct your thoughts and actions. You may hear reassurance like “I can get
through this situation with peace and love” or “I’ve gotten through tough
scenarios before and I can get through this one”.
5.
Keep
coming back to the breath and your inner guide as need be.
Practicing relaxation everyday by meditating, or prayer, or
positive affirmations/self-talk is a great way to reset the stress-o-meter to a
much more peaceful level. When or if we
run into stressful situations, it’s easier to regain that grounded and loving
state through a ‘relaxation breath’ technique as described above.
PS- Thank you, Margaret, for providing the inspiration to
create this blog entry and for sharing in wonderful moments of mutual learning,
peace and joy!
